Laserfiche WebLink
Phone:(714)647-5420 Fax:(714)647.6944 <br />CERTIFICATE OF LIABILITY INSURANCE <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOL.DER- <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statementon <br />this certificate does not confer debts to the certificate hnider in u.,. of Ruch undnru.wnnuaA <br />PRODUCER Triton of Calif Insurance Services, Inc. <br />6000 San Juan Avenue <br />Fair Oaks, CA 95628 <br />License #: OF41767 <br />YISURFD <br />TOM BYSTRY • <br />DBA: VIDEO ENGINEERING SERVICES <br />14 APPOMATTOX <br />IRVINE, CA 92620 <br />.___ INBIMiEii(8)AFFORDWO COVERAGE <br />COVERAGES CERTIFICATE NUMBER: 00003962.9368 REVISION NUMBER: <br />30 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />WG ANY REOUIREMENr, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VATH RESPECT TO WHICH THIS <br />CERTIFICAINDICATEDTE MAY B ISSUE <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBIECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INOR TYPE OF INSURANCE LMra POl1C1'NUYBER I .._... UWTB . <br />A <br />X <br />COM11F 1A1-eaIERALLIAmtnr <br />Y <br />MP0004009006721 <br />02ID1/2020 <br />02rov202t <br />EACH OCCURRENCE <br />a 1,000,000 <br />CLAMBAWDE � 0=R <br />Eq' <br />FA Ou <br />100,000 <br />s 5 000 <br />MED EJw .n. <br />PERBDALAADVINJURY <br />6 1 000 <br />UNTAPPLIEB PEk <br />2 EPALAGCREQAW <br />i 2000000 <br />GEMLAGORELMTE <br />Po Y O PO <br />( <br />6 2,000,000 <br />LOC <br />PR0Dt/GT8-CQNPL AGG <br />6 <br />OTHER' <br />AUTOMOMIE1.1AelUTY <br />COM& I <br />Roakwo <br />6 <br />ANY AUTO <br />eOdLY aMURV(Wrpermr,) <br />a <br />ONNED Ad1EDUlED <br />BOdLY WARY (PN acdOxle <br />i <br />AUTOG <br />AUr090NLY AUTOS <br />!BRED NON-DIMMEDPROPERTY <br />DATA —AGE..._. <br />AUTOS ONLY AUT090NLY <br />i <br />i <br />UMBRELLA LV,B <br />OCCUR <br />i <br />EACH OCCURRENCE <br />a <br />ME"LIAB <br />CUYABAMOE <br />I <br />AGGREGATE <br />DED RETENTIONS <br />6 <br />VA)RNERB cOMPE YciM <br />AND EMPLOYEW LIA&OTY YIN <br />E.L EACNACCIDENT <br />i <br />ANY PROPRIETORRARTIVMDMCUMIE <br />OFFICFlLT¢MBER EXCLUDED? ❑ <br />NIA <br />EL DISEASE -CA EMKOYES <br />6 <br />(N&nWM in NHi <br />II yyes, dw'aa un0er <br />E.LDIBEABE-POLICYLMR <br />i <br />DESCIEIPTgN OF OPERATgNS IMbw <br />OEBCRIPnON OF OPEMTgN81 LocAnotx I VENIDLEa tACOR0101, Atlditierul RPm.Me 8cM0uM, nMY b.11�cM0 it rtpn spec. M r.W IrOdl <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; Its officers, employees, agents and representatives <br />are named as additional insureds per CG2010 attached to this policy. The Insurance is primary and non-contributory. <br />Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation <br />REVIEWED 6 APPROVED <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th-I <br />SANTA ANA, CA 92702 <br />ANqIE <br />SHOULD ANY OF THE ABOVE DESCRIBED POUGES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />©1988-2015 ACORD <br />Fa V. cO IAu'I Oms) The ACORD name and logo am registered marks of ACORD <br />Pnnted by CPR Dn January 22, 2020 at I IS4AM <br />